Individual provider Active NPI

Huma Tariq Khaliq, PA

  • Physician Assistant
  • Torrance, CA
National Provider Identifier
1750389375
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001554 Issued in CT
Practice address
1907 Border Ave
Torrance, CA 90501-3606
Phone
(844) 443-6246
Fax
(833) 907-2235
NPI assigned
Jul 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 001554 CT Primary

Addresses

Primary practice location

1907 Border Ave
Torrance, CA 90501-3606

Mailing address

121 Pierce Blvd
Windsor, CT 06095-4744
Phone (203) 449-1036

Other practice location 1

232 N Elm St
Waterbury, CT 06702-1516
Phone (203) 756-8021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY, NJ, CA, PA, MI6 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20050330001049 CT Practitioner - Physician Assistant 9234185414 Reassigns benefits to 5 organizations
I20240909003072 NY Practitioner - Physician Assistant 9234185414 Reassigns benefits to 2 organizations
I20241009002306 NJ Practitioner - Physician Assistant 9234185414 Reassigns benefits to 2 organizations
I20250408000066 CA Practitioner - Physician Assistant 9234185414 Reassigns benefits to 1 organization
I20250814000861 PA Practitioner - Physician Assistant 9234185414 Reassigns benefits to 1 organization
I20251006000509 MI Practitioner - Physician Assistant 9234185414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile Medical Healthcare PCGroup PAC ID 3072919315, 8 clinicians

Practice addresses (Care Compare)

701 Cooper Rd
Suite 1
Voorhees, NJ 08043-3800
Phone (866) 349-4230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001554CTMDMarriage & Family Therapist
1554CTMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charter Oak Health Center, Inc. CurrentSince May 1, 2019 Accepting new patients
Charter Oak Health Center, Inc. CurrentSince May 1, 2019 Accepting new patients
Aakaish Sanjeevi Home Health Physicians Past Accepting new patients

Locations

21 Grand St
Hartford, CT 06106

Interoperability endpoints

  • Direct secure messaging: huma.khaliq.1@24989.direct.athenahealth.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1750389375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 PIERCE BLVD",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060954744",
            "telephone_number": "203-449-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 BORDER AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905013606",
            "telephone_number": "844-443-6246",
            "fax_number": "833-907-2235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "232 N Elm St",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067021516",
            "country_code": "US",
            "telephone_number": "203-756-8021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHALIQ",
        "first_name": "HUMA",
        "middle_name": "TARIQ",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "001554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.